I think different therapists have different ideas of what therapy is 'supposed' to be about. I also think that the majority of therapists will say there is no 'supposed to' about it, and that different clients are different in how they make use of the time.

If someone asks me 'how are you' I have a reflexive response 'fine'. That is the best I can do. If someone asks me 'what do you want to talk about' I have another reflexive response 'I don't know'. So if that is all the therapist says... That is all they will get in response. Then I'll sit there staring at my hands feeling anxious and inadequate but not really having an idea of where to from there.

So... I personally need the therapist to be kind of directive. To keep on asking questions. To maybe have a little speel about something or other. Eventually... I find myself talking. And once I'm away, then things tick along fairly smoothly, I think.

Could you mention to your therapist that you are having trouble getting started? Different therapists are more or less willing to be directive and / or to take charge of the subject matter of the sessions. But I really do think that most will be able to try and assist you getting talking.

You could also (perhaps)? say that you have been thinking hard about what it might be profitable to talk about, but that you aren't sure about some of it because it seems to be so long ago - even though you suspect it is having an impact now. Maybe say that much and see what your therapist says?

It IS hard. Kudos for hanging in there and thinking about it so hard :-)